Antibiotic Day Research Articles

European Antibiotic Awareness Day, 2008 – the first Europe-wide public information campaign on prudent antibiotic use: methods and survey of activities in participating countries

Antibiotic resistance is a major European and global public health problem and is, for a large part, driven by misuse of antibiotics. Hence, reducing unnecessary antibiotic use, particularly for the treatment of certain respiratory tract infections where they are not needed, is a public health priority. The success of national awareness campaigns to educate the public and primary care prescribers about appropriate antibiotic use in Belgium and France stimulated a European initiative coordinated by the European Centre for Disease Prevention and Control (ECDC), and named European Antibiotic Awareness Day (EAAD), to take place each year on 18 November. Specific campaign materials, including key messages, logos, slogans and a media toolkit, were developed and made available for use in European countries. The focus of the first EAAD campaign was about not taking antibiotics for viral infections such as colds and flu. A post-campaign survey was conducted in January 2009. Thirty-two European countries participated in the first EAAD, producing information materials and implementing activities to mark EAAD. Media coverage peaked on 18 and 19 November. At EU level, EAAD was launched at a scientific meeting in the European Parliament, Strasbourg. The event received EU political engagement through support from the EU Commissioner for Health, the Slovenian and French EU Presidencies, and Members of the European Parliament. Critical factors that led to the success of the first EAAD were good cooperation and process for building the campaign, strong political and stakeholder support and development of campaign materials based on scientific evidence. Countries indicated wide support for another EAAD in 2009. For this purpose, ECDC is developing several TV spots as well as a second set of EAAD campaign materials targeting primary care prescribers.

18 November and beyond: observations on the EU Antibiotic Awareness Day

Antibiotic resistance is among the greatest threats to public health. Public and political concerns have been important drivers of a multifaceted strategy to contain and control this problem. The key components include surveillance of resistant pathogens and more accurate measurement of prescribing practice, in addition to adherence to sound hygiene and infection control practices. With the current inadequate supply of new antibiotics, better use of existing agents is fundamental. An educational strategy must involve the public as well as prescribing professionals. Public educational initiatives and campaigns have been increasingly used, often effectively. To this end, an annual Antibiotic Awareness Day (AAD) has been launched by the European Union (EU) under the leadership of the European Centre for Disease Control. Across Europe, a repertoire of events took place with the aim of raising public and professional awareness of the importance of appropriate antibiotic use. Only time will tell whether the annual 18 November EUAAD will have significant impact. The need to sustain the effectiveness of these drugs suggests that every effort should be made to ensure that it is successful.

Antibiotic awareness day

Antibiotic awareness day

Increasing multidrug resistance and limited treatment options: situation and initiatives in Europe

Antimicrobial resistance due to the continuous selective pressure from widespread use of antimicrobials in humans, animals and agriculture has been a growing problem for decades. In 2001, European Union Ministers of Health adopted Council Recommendations on the prudent use of antimicrobial agents in human medicine. This issue of Eurosurveillance is the second one this month dedicated to antimicrobial resistance, in connection with the first-ever European Antibiotic Awareness Day - a European Union (EU) health initiative involving all key players to increase awareness of Europeans about antimicrobial resistance and prudent use of antibiotics.

The European Antibiotic Awareness Day

The European Antibiotic Awareness Day, which will have as its theme the need to stop unnecessary use of antibiotics, will take place on 18 November 2008. It is hoped that healthcare workers and other professionals, particularly those involved with child care, as well the general public and members of the media, will participate in the various activities and discussions that will take place across Europe as part of this initiative. The European Antibiotic Awareness Day will be an annually recurring event that will raise awareness about the risks associated with inappropriate use of antibiotics and how to use antibiotics responsibly.

Risk factors for asthma at 3.5 and 7 years of age

It has been suggested that factors in early life including exposure to allergens and microbes may influence the development of asthma. To identify risk factors for asthma in early childhood. Methods Eight-hundred and seventy-one children of European mothers were enrolled at birth, of whom 385 (44.2%) were born small for gestational age (SGA) and 486 were appropriate for gestational age (AGA). Data were collected at birth, 12 months, 3.5 years of age (y) and 7 y. The outcome of interest (current wheeze) was defined as a positive response to the question: 'Has your child had wheezing or whistling in the chest in the last 12 months?' Participation rate was 85.4% at 1 y, 63.1% at 3.5 y and 68.0% at 7 y. The prevalence of asthma was 23.8% at 3.5 y and 18.1% at 7 y. Antibiotic use in the first year of life and day care in the first year of life were associated with increased risk of wheeze at 7 y [odds ratio (OR)=4.3 95% confidence interval (CI) (1.8-10.1) and OR=2.8 95% CI (1.2-6.5), respectively], but not at 3.5 y. Exposure to dogs was a risk factor for asthma at both ages [OR=2.1 95% CI (1.1-3.8)] as was sleeping on a used cot mattress in the first year of life [OR=1.8 95% CI (1.0-3.2)]. There was a significant association between antibiotic use and day care in the first year of life and wheezing at 7 y but not at 3.5 y. This strengthens the argument that these factors increase the risk of asthma. We have also made the novel observation that sleeping on a used mattress in the first year of life is a risk factor for wheezing at 3.5 and 7 y. Capsule summary This prospective study of 871 children made the novel observation that sleeping on a used mattress in the first year of life was a risk factor for wheezing at 3.5 and 7 y.

Benchmarks for Antibiotic Use and Cost in Long‐Term Care

To evaluate previously described antibiotic use and cost indicators in community nursing homes to determine whether they may be useful as benchmarks and to evaluate the association between functional status, infection occurrence, and antibiotic use. Retrospective observational study. Eleven proprietary long-term care facilities owned by one company. Only facility-specific cumulative data were used. Antibiotic use and cost indicators (incidence of antibiotic use, antibiotic utilization ratio, cost of antibiotics per resident care day (RCD), and cost per antibiotic day), infection rates, and functional status as measured using the case-mix index (CMI) of the Resource Utilization Groups II system. Mean yearly values for each measure were calculated for each facility. There was significant variation in all of the antibiotic indicators between the 11 nursing homes, but there was no correlation between mean facility CMI and infection rate. However, there was a trend toward a significant correlation between mean facility CMI and mean facility incidence of antibiotic use, antibiotic utilization rate, and cost per RCD. Variation in mean facility infection rate explained 66% of the variation in mean facility incidence of antibiotic use (P<.001). In a multivariate analysis, mean facility infection rate (P=.003) and mean facility CMI (P=.046) were predictors of mean incidence of antibiotic use and explained 83% of the variation in dependent variable. The significant variation in mean antibiotic use and cost indicators between the 11 study facilities suggests that these indicators may be useful as benchmarks for quality-improvement efforts. For the first time, objective evidence is provided demonstrating the influence of functional status on antibiotic use in the nursing home setting.

Antibiotic use and cost indicators at a rural hospital: A pilot project

Background: Recently, simple antibiotic use and cost indicators were developed for use in long-term care facilities. It was hypothesized that these indicators also may be applicable to the acute hospital setting. Methods: For a 24-month period, data were collected quarterly on antibiotic use and cost indicators for 11 primary care physicians in a 40-bed rural hospital. Indicators included antimicrobial use ratio (AUR, ratio of the number of antibiotic days to the number of patient care days), cost per antibiotic day, and cost of antibiotics per patient care day. One-way analysis of variance and simple linear regression were used to analyze data. Results: Quinolones (oral plus parenteral) accounted for 26% of the total antibiotic days (N = 6020) followed by ceftriaxone (19%) and cefuroxime (11.8%; oral plus parenteral). Overall trends in antibiotic use and cost included a significant increase in quarterly AUR (R2 = 0.78, P =.004) and cost per patient care day (R2 = 0.82, P =.002) but no significant change in quarterly total antibiotic costs or cost per antibiotic day. Among physicians there was a significant difference in mean quarterly AUR (P <.001) and mean quarterly cost per patient care day (P <.001) but no significant difference in mean quarterly cost per antibiotic day. Variation in physician-specific cost per patient care day was best explained by variation in AUR (R2 = 0.75, P <.001). Conclusions: Significant variation in simple antibiotic use and cost indicators was identified at a rural hospital from both the facility and physician perspective. Standardized methods for antibiotic use and cost monitoring, like the one described in this article, are required before the relationship between antibiotic use and resistance can be fully understood. (AJIC Am J Infect Control 2000;28:415-20)

Vancomycin-Induced Neutropenia during Treatment of Endocarditis in a Pediatric Patient

To report a case of reversible vancomycin-associated neutropenia occurring during long-term therapy with vancomycin using weight and age-adjusted dosing. A 2-year-old boy was started on vancomycin therapy for presumed endocarditis resulting from his ventriculoseptal defect. After 18 days of treatment, neutropenia with an absolute neutrophil count (ANC) of 990 x 10(6) cells/L was noted. The neutropenia progressed over the next 3 days and reached a nadir concentration of 459 x 10(6) cells/L. Vancomycin therapy was discontinued after 17 days (antibiotic day 20). A rise in the ANC occurred within 2 days of discontinuation. An improved ANC of 1672 x 10(6) cells/L occurred within 5 days. Vancomycin serum concentrations remained within an acceptable range: a peak of 30 micrograms/mL and a trough of 9 micrograms/mL. Case reports in the literature of vancomycin-associated neutropenia in adults were briefly reviewed and compared. The onset and resolution and mechanism of vancomycin-induced neutropenia were studied. The potential relationship between vancomycin, weight-, and age-adjusted dosing and the occurrence of neutropenia in our pediatric patient was postulated. Vancomycin is identified as a possible cause of drug-induced neutropenia. More data are needed that clearly indicate vancomycin as the offending agent in children. The vancomycin-induced neutropenia is believed to be immunologically based and independent of drug concentrations.

Antibiotic cost savings from formulary restrictions and physician monitoring in a medical-school-affiliated hospital

Strictly enforced antibiotic formulary restrictions for aminoglycosides, cephalosporins, and a vancomycin group generated combined savings of $2.61 (p <0.0046) per antibiotic day and $34,597 (p <0.0003) per month. Even after some cost increases (not significant) in new and other antibiotics, the program saved $1.33 (p <0.0175) per antibiotic day and $24,620 (p <0.0311) per month for all antibiotics. The pharmacy's 1985 average cost per antibiotic day and its monthly expenditures were $18.45 and $199,003, respectively. In the months following the formulary restrictions, no significant detrimental changes occurred in hospital length of stay or mortality. A retrospective analysis of 322 patients with bacteremia treated before and after the onset of the controls revealed that antibiotics were more appropriately used afterwards.